Multiple subcutaneous nodules as a rare presentation of alveolar rhabdomyosarcoma.

Abstract

Rhabdomyosarcoma (RMS) is the third most common extracranial solid tumour of child-hood originating from mesenchymal cells that can present, rarely, as multiple skin nodules. We report a 12-year-old boy who presented with generalized body pain and multiple painless skin nodules. Surgical removal and pathologic assessment revealed cutaneous alveolar RMS. Immunohistochemical analyses were positive for vimentin, actin, and desmin, thus consistent with RMS. Chemotherapy, which is the first choice therapy for disseminated RMS, partially improved the skin nodules in number and size, and reduced body pain. Solitary cutaneous RMS presenting in young age has a better prognosis than the metastatic type in older age. Physicians should consider this rare presentation of RMS, as one of small round cell tumors, in order to reach a prompt diagnosis and begin appropriate management.